Provider Demographics
NPI:1609271816
Name:DILLENBECK-JUERS, JULIE ANN (MS, APRN, FNP-BC)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:ANN
Last Name:DILLENBECK-JUERS
Suffix:
Gender:F
Credentials:MS, APRN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:99 E STATE ST
Mailing Address - Street 2:
Mailing Address - City:GLOVERSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:12078-1203
Mailing Address - Country:US
Mailing Address - Phone:518-775-4300
Mailing Address - Fax:518-775-4192
Practice Address - Street 1:99 E STATE ST
Practice Address - Street 2:
Practice Address - City:GLOVERSVILLE
Practice Address - State:NY
Practice Address - Zip Code:12078-1203
Practice Address - Country:US
Practice Address - Phone:518-775-4300
Practice Address - Fax:518-775-4192
Is Sole Proprietor?:No
Enumeration Date:2014-10-30
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY338805363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL037515200Medicaid
FL037515200Medicaid
CTMD4766385OtherDEA REGISTRATION NUMBER